There is general acknowledgement that both the anterior cingulate and orbitofrontal cortex are implicated in reinforcement-guided decision making, and emotion and social behaviour. Despite the interest that these areas generate in both the cognitive neuroscience laboratory and the psychiatric clinic, ideas about the distinctive contributions made by each have only recently begun to emerge. This reflects an increasing understanding of the component processes that underlie reinforcement- guided decision making, such as the representation of reinforcement expectations, the exploration, updating and representation (...) of action values, and the appreciation that choices are guided not just by the prospect of reward but also by the costs that action entails. Evidence is emerging to suggest that the anterior cingulate and orbitofrontal cortex make distinct contributions to each of these aspects of decision making. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:66 IN DEFENCE OF KEMP SMITH D. C. Stove argues against Kemp Smith's contention that Hume's philosophy "was intended not to subvert but to endorse our natural beliefs" in general, and our belief in the Causal Principle in particular. His arguments are insufficient. Kemp Smith does not need to deny that the falsity of the Causal Principle is believed by Hume to be possible in the strongest of Stove's (...) three suggested 2 senses: it is not merely self-consistent, but the Principle is unverifiable and unconfirmable in the sense that no empirical proposition is relevant to its truth. However, to say flatly that its falsity is possible is to say that it is not impossible in any way at all; and that is what is at stake both in Hume's letter to Stewart and in the use Kemp Smith makes of it. If Hume had written a letter to Stewart or to any scientific enquirer urging him to desist from his labours on the ground that "something may begin to exist, or start into being without a cause," he would have been a fool, and in representing Hume's position in this way Stewart is in fact calling Hume a fool. It is not surprising that Hume is indignant. The problem is whether, and how, one can hold both that the Causal Principle is undeniably true and that it can be supported neither by deductive nor by inductive argument, and whether Hume on the most reasonable interpretation of his published works held both these views. Clues to the answer lie in the in tradition of sceptical philosophy, and in the difference between a cause and a reason. Hume's philosophy is indeed, as he says, 'very sceptical'. But scepticism is a kind of philosophy with a long history, from Sextus Empiricus to Bayle, and it is reasonable to suppose that Hume was aligning himself with this position, especially since so much of the argument in 67 the Treatise is derived from Bayle. But sceptics do not behave otherwise than ordinary men. Scepticism is not directed against everyday beliefs but again.st arguments: this is a point on which Sextus insists." It would not be the part of a sceptic to doubt that every event has a cause, but to refute all arguments purporting to show that such is the case. To assert "that any thing might arise without a Cause" would not be scepticism, but an inverse dogmatism: to infer from a philosophical argument a belief about the real world that is at variance with everyday belief. The crucial step in Stove's argument occurs in his gloss of Hume's claim that he had maintained "that our Certainty of the Falsehood of that Proposition proceeded neither from Intuition nor Demonstration; but from another Source" phrase "sic., experience, of course". This could be misleading. It could mean that Hume here claims that experience gives us reason to believe that the Causal Principle is true; and this Hume has denied, as Stove urges ad loc. But nothing in what Hume says in his letter requires us to interpret him thus. And his sceptical principles tell against it: an argument from experience, whether inductive or by analogy or whatever, is still an argument and thus liable to sceptical attack. What Hume could mean, and what Kemp Smith took him to mean, is that our experience causes us to regard the principle as necessary: experience is not a premise in any sort of argument at all, but a causal explanation for a universal propensity to believe in the Causal Principle. It is true that Hume's citation as analogues of such empirical affirmations as "That Caesar existed" is misleading. But it is not in fact the case that Hume represents these as in any way 'parallel' with the Causal Principle: he says only that, like it, They are believed without recourse to Reason and Intuition. In 68 point of fact, Stove is going a bit far when he says that this is (like "There is such an Island as Sicily") an observation-statement; but that point is hardly relevant here. It is worth noting that in the offending passage... (shrink)

Aim: To improve clinical and ethical understanding of patient preferences for information and involvement in decision making.Objectives: To develop and evaluate a clinical tool to elicit these preferences and to consider the ethical issues raised.Design: A before and after study.Setting: Three UK hospices.Participants: Patients with advanced life-threatening illnesses and their doctors.Intervention: Questionnaire on information and decision-making preferences.Main outcome measures: Patient-based outcome measures were satisfaction with the amount of information given, with the way information was given, with family or carer information, (...) and confidence about future decision making. Doctor-based outcome measures were confidence in matching information to patient preference, matching family or carer communication to patient preference, knowing patient preferences and matching future decision making with patient preference.Results: Of 336 admissions, 101 patients completed the study . Patient satisfaction with the way information was given and family communication improved after introduction of the tool. Doctor confidence improved across all outcome measures .Conclusions: Patient satisfaction and doctor confidence were improved by administering the questionnaire, but complex ethical issues were raised by implementing and applying this research. The balance of ethical considerations were changed by advanced life-threatening illness, because there is increased risk of harm through delivery of information discordant with the patient’s own preferences. The importance of truly understanding patient preferences towards the end of life is highlighted by this study. (shrink)

Controversy and activism have long been linked to the subject of primate research. Even in the midst of raging ethical debates surrounding fertility treatments, genetically modified foods and stem-cell research, there has been no reduction in the campaigns of activists worldwide. Plying their trade of intimidation aimed at ending biomedical experimentation in all animals, they have succeeded in creating an environment where research institutions, often painted as guilty until proven innocent, have avoided addressing the issue for fear of becoming targets. (...) One area of intense debate is the use of primates in stroke research. Despite the fact that stroke kills more people each year than AIDS and malaria, and less than 5% of patients are candidates for current therapies, there is significant opposition to primate stroke research. A balanced examination of the ethics of primate stroke research is thus of broad interest to all areas of biomedical research. (shrink)